Submit A Claim

Submitting a claim is as easy as answering the question below and then filling out the form that follows.

Please select ONE of the following:*

I am insured with American Alliance

I was involved in a loss with someone insured with American Alliance

Other – Party not involved in the loss (agents, carriers etc.)

Please add all other parties involved

Not Applicable – Single Car Loss

Other Driver's & Vehicle Information

Your Vehicle Information

Please Add All Other Parties

Additional Vehicles

Add up to 5 additional vehicles involved in the loss.

Additional Vehicle #1

Additional Vehicle #2

Additional Vehicle #3

Additional Vehicle #4

Additional Vehicle #5

Passengers Information

Were there any passengers inside your vehicle at the time of the loss?*

Yes

No

Were there any passengers inside your clients vehicle at the time of the loss?*

Yes

No

Were there any passengers inside any of the other vehicles at the time of the loss?*

Yes

No

Unknown

Name of Person Completing Form*

Email Address*

Enter Email Address below to receive confirmation of your Claim Submission & Next Steps

Phone Number*

Submit A Claim

Basic Information

American Alliance Driver's Information

American Alliance Vehicle Information

Other Driver's & Vehicle Information

Your Vehicle Information

Please Add All Other Parties

Additional Vehicles

Additional Vehicle #1

Additional Vehicle #2

Additional Vehicle #3

Additional Vehicle #4

Additional Vehicle #5

Description of Accident

Passengers Information

Customer Area

Submit A Claim

Basic Information

American Alliance Driver's Information

American Alliance Vehicle Information

Other Driver's & Vehicle Information

Your Vehicle Information

Please Add All Other Parties

Additional Vehicles

Additional Vehicle #1

Additional Vehicle #2

Additional Vehicle #3

Additional Vehicle #4

Additional Vehicle #5

Description of Accident

Passengers Information

Producer Login

Customer Area